Category: Covid-19

Early detection and early response. In an ideal world, this will contain an outbreak of infectious disease and prevent it from establishing in a population and becoming an epidemic.

Containment typically involves isolating and testing suspected cases, tracing their contacts, and quarantine in case any of these people are infected. The more thorough the testing and contact tracing early on, the better the chance of containment. These measures work well, especially for diseases like Sars, where symptoms coincide with infectiousness it is easy to recognise people who are infected.

In the case of Covid-19, detection is much harder because some transmission is possible before people show obvious symptoms, in this case a fever and cough. If there are no symptoms, it is impossible to identify people who are infected unless they are tested and their infection is confirmed in a laboratory, which is why airport screening at arrival is not very effective for Covid-19. This makes the virus much harder to control. Sooner or later, an infected case escapes detection and starts a chain of transmission, and quickly leads to a growing number of cases, which can become impossible to contain. As a result, containment has failed in a number of countries and the World Health Organization has declared a pandemic that is here to stay for months, if not longer.

So how does an epidemic spread through a population and how do we control it? In outbreak analysis, we measure transmission using the reproduction number (otherwise known as R), which tells us how many other people a typical Covid-19 case will infect on average. If one person is expected to infect more than one other person, the infection will grow and create an outbreak; if a person infects less than one other, the infection will peter out.

The larger the value of R, the easier the virus spreads through a population and the higher the number of infections. For seasonal flu, one infection leads on average to 1.4 new infections. For Covid-19, one infection leads to 2-3 others in the early stages of an outbreak. How many other people we end up infecting depends on several things: how many susceptible people there are in the population, how long we are infected for (the longer we are infected the more chances there are to pass on the infection), the number of people we come into contact with, and the probability of passing on the infection to those contacts.

In order to control the epidemic, we need to reduce R below 1. For diseases such as measles, we can achieve this by vaccinating a large enough proportion of the population so that the disease can no longer spread. Exactly what proportion we need to vaccinate to reach community immunity depends again on R. For R of 2, we need to immunise half of the population to interrupt transmission; for R of 3 we need to immunise two thirds of the population to get R below 1.

However, an effective vaccine for Covid-19 is unlikely to be available for another 12-18 months at best.

Shortening the duration of infection could also reduce transmission, and for some infections, such as influenza, this can be achieved with antiviral therapy. There are currently more than a hundred clinical studies in progress, which could produce therapies that reduce the duration of infection or infectivity. However, both of these control options are not yet available.

Another option to reduce the duration of infection is continued testing; this is a measure that can be effective throughout the epidemic. Finding infected people and advising them to self-isolate for the duration of the infection minimises the risk of them passing on the infection, which therefore slows down the spread. This is again a basic intervention method that we know works well, but in order for it to be most effective, results need to be processed quickly (in the UK it takes 2-4 days to get the results, in Wuhan it is under 4 hours).

If we cant easily reduce susceptibility or duration, we are left with two things: the probability of transmitting the infection upon contact and the number of different people we come into contact with. Both of these are things we as individuals can change by modifying our behaviour. Washing hands frequently for 20 seconds with hot water and soap, not touching our faces, covering our coughs and sneezes, staying at home if we are sick all of these reduce the risk of getting infected or passing on the infection to someone else.

Cancelling large gatherings, working from home and school closures are all social distancing measures aimed at reducing the number of contacts between people, each of which is an opportunity for passing on an infection. But this will not be a simple case of just cancelling events and closing schools for a couple of weeks. More severe measures will be necessary to bring the infections to low enough levels to keep the pressure off the health-system long-term. As individuals, we must all reduce the number of different people we come into contact with on a daily basis, and be prepared to do so for a prolonged period of time.

But what sorts of contacts are most important for transmission? Together with Adam Kucharski, also from the London School of Hygiene and Tropical Medicine, I have recently collaborated with the BBC on a massive citizen science project, led by Professor Julia Gog from Cambridge University. Called BBC Pandemic, the project collected information on how people of different ages interact with one another in different contexts (home, work, school, other) from over 35,000 volunteers. We have recently been fast-tracking the release of contact data to help inform UK Covid-19 modelling efforts and potential intervention strategies.

What we have found in this data is that adults aged 20-50 make most of their contacts in workplaces. If those of us who can work remotely start doing so now, it will contribute to lowering overall transmission in the population. Another important finding is that people over 65 who are particularly at risk from severe Covid-19 illness make over half of their contacts in other settings (not home, school or work), such as shops, restaurants and leisure centres. By avoiding these interactions, people who are most at risk from the new coronavirus could halve their risk of infection. By changing our behaviour now, and sustaining these changes throughout the outbreak, we can significantly reduce our own risk of infection, and the risk to others, and by doing so help protect those most vulnerable.

Sustainability is key here; these measures may reduce the reproduction number R, but as soon as they are lifted we could see transmission again, and another outbreak.

We must all take individual action to reduce Covid-19 transmission and slow down its spread, limit the number of infections and reduce the pressure on the health system so that everyone who needs medical care can get it. Starting now, and for the duration of this epidemic, we all have a role to play and a responsibility to modify our behaviour in order to protect the ones who are most at risk.

Dr Petra Klepac is assistant professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine

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What we scientists have discovered about how each age group spreads Covid-19 - The Guardian

Here is a 3D image of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), formerly ... [+] known as the 2019 novel coronavirus (2019-nCoV). (Image: Getty)

Dont you just love conspiracy theories? Especially when two groups of people have pretty much the same conspiracy theory about each other?

Some folks including politicians in the U.S. and China have both suggested that the COVID-19 coronavirus (SARS-CoV2) thats causing the pandemic may actually be a bioweapon that was manufactured in a lab. The only difference between their conspiracy theories is whos being accused of doing the manufacturing.

On the one corner are some people in the U.S. who are hinting or in some cases openly claiming that China put together this virus. For example, look at what Senator Tom Cotton (R-Arkansas) tweeted out back on January 30:

Then, Steve Mosher wrote on February 22 an opinion piece for the New York Post entitled, Dont buy Chinas story: The coronavirus may have leaked from a lab. Take a wild guess at what Mosher wrote about in his piece. By the way, Mosher is not a biomedical scientist, but instead is the president of the Population Research Institute and author of book called Bully of Asia: Why Chinas Dream Is the New Threat to World Order. So chances are that he didnt love China in the first place. But who knows, love works in mysterious ways.

So what evidence have Cotton, Mosher, and others provided to support these suggestions or claims? Incriminating pictures? Suspicious emails? Some awkward selfies? Any kind of scientific evidence?

Well, as Cotton picked out, there just happens to be a biosafety level-four (BSL-4) laboratory situated in Wuhan, China, the city where the whole outbreak started. Oh, and the lab had housed some types of coronaviruses among other pathogens. Yep, thats the evidence.

As you probably know, proximity alone should not imply guilt. That would be like claiming that you farted whenever theres a bad smell and you happen to be in the vicinity. Sure you may have intestines but that doesnt mean that every foul stench emanated from your guts.

Plus, its a lot easier to leak a pocket of air though your butt than a virus from a BSL-4 facility. BSL-4 facilities maintain the highest level of security among bio-laboratories since they do work on dangerous potentially life-threatening agents such as the Ebola, Lassa fever, and Marburg viruses. So its not as if the people inside these labs are playing throw and catch with the viruses and stuffing them into their pockets. To be designated as a BSL-4, the lab has to have the appropriate ventilation systems, reinforced walls, security systems, and construction to keep the wrong things inside and the right things outside.

Is it unusual then to have a BSL-4 facility in a city like Wuhan, China? Not really. There are already at least six BSL-4 facilities in the U.S. in Atlanta, GA, Frederick, MD, Galveston, TX, Hamilton, MT, and San Antonio, TX. According to the Federation of American Scientists website, seven others may be planned, under construction, or possibly finished in various cities such as Boston, MA, and Richmond, VA. These labs in the U.S. also study and house a range of dangerous pathogens. So again having a lab that studies bad pathogens does not mean that the lab released anything.

Not to be outdone, some in China have made similar suggestions, except that its the U.S. that built the virus and released it in China. Well, thats original. For example, take a look at these three tweets from Zhao Lijian, Spokesperson and Deputy Director General, Information Department for the Foreign Ministry of China:

Yes, the claim is that the U.S. released a virus in China so that the U.S. can then eventually suffer the consequences of the spreading virus just a couple months later. Makes a whole lotta sense, except that it doesnt. Where exactly is the real evidence that the U.S. military created SARS-CoV2?

The back-and-forth dialogue has continued with President Donald Trump then referring to SARS-CoV2 as the Chinese Virus as can be seen here:

When questioned why he was using this label rather than the real scientific name of the virus, Trump claimed that it was in response to the claim that the U.S. military had created the virus. The video accompanying the following tweet shows the exchange:

Back and forth. Back and forth. Back and forth.

So, it looks like conspiracy theorists on both sides havent really provided any compelling evidence that SARS-CoV2 was produced in a lab, whether in the U.S., in China, or in the Hogwarts School of Witchcraft and Wizardry.

In fact, there is not only a lack of evidence supporting these conspiracy theories, there has been growing strong scientific evidence against both of them. Scientists, you know the ones who are actually trying to find the truth and solve a problem rather than blame people, have been conducting genetic analyses to determine where the virus came from and how it ended up infecting humans. Although viruses arent exactly like people as they dont seem to have feelings or spread rumors, viruses do have genetic material like people, except their genetic material is not quite as complex as those of humans. Nevertheless, like humans, viruses still pass along such materials when they replicate and evolve. Its not as simple as The Jerry Springer Show using genetic testing to find out if a guy is someones father, but scientists can use more advanced genetic analysis to figure out the origins, the family tree of SARS-CoV2.

Indeed, strong clues had already emerged by February 26, 2020, when a Perspectives piece was published in the New England Journal of Medicine. In the piece, David M. Morens, M.D. and Peter Daszak, Ph.D. from the National Institute of Health (NIH) and Jeffery K. Taubenberger, M.D., Ph.D. wrote: Of course, scientists tell us that SARS-CoV-2 did not escape from a jar: RNA sequences closely resemble those of viruses that silently circulate in bats, and epidemiologic information implicates a bat-origin virus infecting unidentified animal species sold in Chinas live-animal markets.

This wasnt exactly a case of same bat channel, same bat time. But the first, more deadlier SARS virus seemed to cause the 2002-2003 outbreak after it had managed to jump from bats to humans via intermediate hosts such as masked palm civets. Yes, some masked beings may have inadvertently partnered with bats to bring the original SARS virus to humans. So it wouldnt be too surprising if something like that happened again for SARS-CoV2.

This illustration shows a close-up of the protein spikes on SARS-CoV2. (Image: Getty)

Even more evidence of a natural rather than human-made origin for SARS-CoV2 has emerged from a study described in a research letter just published in Nature Medicine. In the letter, a research team (Kristian G. Andersen from The Scripps Research Institute, Andrew Rambaut from the University of Edinburgh, W. Ian Lipkin from the Mailman School of Public Health of Columbia University, Edward C. Holmes from The University of Sydney and Robert F. Garry from Tulane University) described how they had analyzed the genetic sequences that code for the protein spikes on the surface of SARS-CoV2. The virus looks sort of like a medieval mace with multiple spikes sticking out from its spherical shape. These spikes arent just for show as the virus uses them to latch on to a cell that it wants to invade and then push its way into the cell. Very medieval stuff.

Apparently, portions of these spike proteins are so effective in targeting specific receptors on human cells that it is hard to imagine humans manufacturing them, not with known existing technology. The researchers then concluded that this feature and thus the new coronavirus could have in all likelihood only evolved over time naturally. You see humans can make useful stuff like ride-sharing apps but are still quite puny compared to nature when it comes to making stuff like viruses.

In fact, the research team found that the SARS-CoV-2 structure in general is quite different from what humans would have likely concocted. If a human had wanted to create a viral weapon, he or she would have started with the structure of a virus thats already known to cause illness in people. Naturally, if you want to make a weapon, you may want to start with something like a grenade launcher rather than a smoothie maker, not that the virus looks like either. Instead, the structure of SARS-CoV2 is quite similar to those of viruses known to infect bats and pangolins.

So all of this further supports the theory that the virus jumped from bats to humans via some intermediate animal host. This doesnt necessarily mean that the virus started causing trouble as soon as it started infecting humans. An alternative possibility is that it jumped a longer time ago and hung out among humans for a while before eventually evolving into its current troublesome selves. This latter possibility would be somewhat analogous to inviting someone to live with you because he or she initially seemed relatively harmless but then over time finding out that this flat mate has become a terror.

The findings from the genetic analyses are consistent with how SARS-CoV2 is currently behaving. The virus is not acting like a bio-weapon right now. The best bio-weapons kill at a much higher rate and can be readily transported and released. Imagine being told that a bio-weapon might take the lives of 1% to 3.4% of the people that it infects but you dont quite know specifically which ones. The difference between SARS-CoV2 and pathogens like the Ebola Virus or anthrax is like the difference between a bunch of sofas and a collection of missiles. Sure, the former can cause harm but not in a predictable and consistent manner. If someone actually decided to develop SARS-CoV2 as a bio-weapon, that person needs to find a new job.

So there you have it: scientific evidence trumping conspiracy theories. Will all of these scientific findings finally quash the virus-was-made-in-a-lab-and-it-is-your-fault rhetoric between the politicians and on social media? Probably not. Since when has science stopped such political rhetoric. Maybe, though, it will get more people to focus on the much more important matter at hand: trying to control this pandemic together.

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Is COVID-19 Coronavirus A Bioweapon From A Lab? Here Is What Debunks This Theory - Forbes

By ClarksvilleNow.com March 16, 2020 3:57 pm

NASHVILLE, Tenn. (CLARKSVILLENOW) The Tennessee Department of Health is now reporting 52 confirmed cases of coronavirus (COVID-19) in the state. The number of cases in Davidson and Williamson County continues to increase. There are still no reported cases in Montgomery County.

Campbell 1 (note: For those who may be un-aware there is a county in Tennessee named Campbell County)Davidson 25Hamilton 1Jefferson 1Knox 1Rutherford 1Sevier 1Shelby 2Sullivan 1Williamson 18

Governor Lee has asked all Tennessee schools to close as soon as possible. (Read more) Practicing social distancing is one way the CDC has recommended limiting the spread of the virus.

In response, ,any retailers have begun to limit their hours and events have been postponed to decrease large gatherings.

The Tennessee Department of Health has now released additional information regarding individuals who have contracted the virus.

Age Range | Number of CaseNull 235-18 years old 119 30 years old 631 40 years old 341 50 years old 1151 64 years old 565+ years old 2

The Centers for Disease Control continues to remind all Americans that proper hygiene and good judgement will help to combat the spread of the virus.

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COVID 19: Tennessee confirmed cases reaches 52, Dept of Health releases age ranges of those infected - Clarksville Now

Housing associations are under pressure to offer rent holidays after only one pledged not to evict any tenant in arrears due to self-isolating because of the coronavirus.

Millions of people live in 2.4m homes let by housing associations across England, Scotland and Wales. Rents are expected to rise by 2.7% from next month and there are fears many people will be unable to pay after losing work or due to being in self-isolation.

The Labour party has urged the government to ban the eviction of tenants whose income has been hit by the outbreak and to allow rent deferrals. On Tuesday, the government said homeowners in financial difficulty due to coronavirus would be offered a three-month mortgage holiday.

However, those who live in housing association accommodation are more likely to work in the gig economy or have precarious contracts, with some out of work because of the impact of the pandemic.

Research by the homeless charity Crisis suggests there were more than 25,000 households evicted from housing associations in 2018, the lowest level since 2000, after a gradual exclusion of the poorest tenants from newly available properties.

The Guardian contacted scores of housing associations some of which describe themselves as companies with a heart but only one confirmed it would introduce measures to prevent the evictions of those who could not pay their bills because of Covid-19.

We will stay in regular contact and not initiate any action for rent arrears while they are experiencing difficulties as a result of the virus, said Sarah Sargent from Radian Group, which has 80,000 tenants across south and south-west England.

Our goal is always for our customers to maintain their tenancies and our tenancy sustainment team already provide support to customers.

Other large housing associations said they relied on rental income but were monitoring the situation closely amid business continuity planning, while others said they rarely evicted people.

Symptoms are defined as either:

NHS advice is that anyone with symptoms shouldstay at home for at least 7 days.

If you live with other people,they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

After 14 days, anyone you live with who does not have symptoms can return to their normal routine. But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start.Even if it means they're at home for longer than 14 days.

Information: If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.

If you have to stay at home together, try to keep away from each other as much as possible.

After 7 days, if you no longer have a high temperature you can return to your normal routine.

If you still have a high temperature, stay at home until your temperature returns to normal.

If you still have a cough after 7 days, but your temperature is normal, you do not need to continue staying at home. A cough can last for several weeks after the infection has gone.

Source:NHS Englandon 18 March 2020

A source with knowledge of discussions between housing associations regarding the scheduled rent increase said events were developing quickly and there was a concern people would not be able to pay rents at all. In 2017, the UKs housing associations made record operating profits of 3.5bn.

Crisis called on the government to ensure renters were not put at greater risk of eviction and homelessness.

Crisis is calling for a temporary suspension of evictions of both social and private tenants, said Matt Downie the charitys policy director. We are already seeing other countries implement such measures and urge the UK to take similar action as a matter of urgency.

We would expect all social landlords to adopt the practice of the best, and ensure tenants who experience loss of earnings because of the pandemic are supported so that they are not at risk of homelessness.

The G15 housing associations, which are responsible for about 600,000 homes in London, welcomed the extension of statutory sick pay 94 a week to include people advised to self-isolate because of Covid-19 and urged those ineligible to claim universal credit or employment support allowance.

We are continuing our rent collection processes as normal, which include significant support for tenants experiencing hardship for whatever reason, a spokesperson said. G15 housing associations only use evictions in the absolute last resort.

Chyrel Brown, the chief operating officer at One Housing, said: We will continue to collect rents as we rely on this income to deliver essential services. We always offer advice and support to residents who find it difficult to pay their rent and will continue to offer this vital support.

Simon Nunn, an executive director at the National Housing Federation, said: As charitable organisations [housing associations] are set up to support vulnerable residents and this includes helping those who may struggle financially by providing advice, help with budgeting and access to benefits.

Many are working to put additional measures in place to support residents that may fall into rent arrears to get back on their feet.

Link:

Housing associations under pressure to offer Covid-19 rent holidays - The Guardian

There have now been 11 coronavirus-related deaths in California. Among the people who have died is a woman who was a substitute teacher in the Sacramento City Unified School District. The woman was identified as Gayle Alexis. KCRA3 reached out to her family, but they are not ready to speak publicly. Longtime friend Carolyn Tillman said Alexis was also an active member at Faith Presbyterian Church in Sacramento's Pocket neighborhood.The minister sent out an email Sunday evening," Tillman said. She was cheerful, upbeat, loved children -- a joy to be around -- and will just really be missed because of her positive attitude about life and the fact that she helped me with a childrens choir for quite a few years, (which) was just a real positive thing for me." Tillman said the two knew each other for more than 20 years at church, and that Alexis retired from Matsuyama Elementary in Sacramento and then continued as a substitute teacher.She certainly didnt need it for the income -- she did it because she loved children," Tillman said. "And she was doing it, at times I think, to help out a friend. Because she enjoyed the classroom and was good in the classroom. Although Sacramento City Unified would not directly confirm the identity of the substitute teacher who died, in a statement it said it became aware Wednesday of an individual who worked in a Sutterville Elementary classroom as a temporary volunteer. The district said a substitute teacher in February had tested positive for COVID-19. The school was disinfected immediately after the district was notified. On the churchs website, the pastor said that as of Saturday, five members of the church have tested positive for COVID-19 and that others were symptomatic, awaiting testing results. "To date, there have been a small number of confirmed positive cases in the congregation. Sadly, one of those has died," Faith Presbyterian Church said in a statement to KCRA3. "On March 12, Faith Presbyterian Church staff discovered that a small number of church members were displaying symptoms potentially associated with COVID-19. That evening, the church leadership met and made the immediate decision to close the church facility on Florin Road to prevent spread of the virus in our congregation and community."The church added it is closed until at least April 3. Its dismaying that testing is still so limited because based on those five (people), that probably every active church member should be tested," Tillman said. "Because who knows? I could be a carrier. So it would probably be reassuring to know that I am not carrying it, and therefore I am not risking my grandchildren carrying it to somebody else.

There have now been 11 coronavirus-related deaths in California. Among the people who have died is a woman who was a substitute teacher in the Sacramento City Unified School District.

The woman was identified as Gayle Alexis. KCRA3 reached out to her family, but they are not ready to speak publicly.

Longtime friend Carolyn Tillman said Alexis was also an active member at Faith Presbyterian Church in Sacramento's Pocket neighborhood.

The minister sent out an email Sunday evening," Tillman said. She was cheerful, upbeat, loved children -- a joy to be around -- and will just really be missed because of her positive attitude about life and the fact that she helped me with a childrens choir for quite a few years, (which) was just a real positive thing for me."

Tillman said the two knew each other for more than 20 years at church, and that Alexis retired from Matsuyama Elementary in Sacramento and then continued as a substitute teacher.

Courtesy of Carolyn Tillman

She certainly didnt need it for the income -- she did it because she loved children," Tillman said. "And she was doing it, at times I think, to help out a friend. Because she enjoyed the classroom and was good in the classroom.

Although Sacramento City Unified would not directly confirm the identity of the substitute teacher who died, in a statement it said it became aware Wednesday of an individual who worked in a Sutterville Elementary classroom as a temporary volunteer. The district said a substitute teacher in February had tested positive for COVID-19. The school was disinfected immediately after the district was notified.

On the churchs website, the pastor said that as of Saturday, five members of the church have tested positive for COVID-19 and that others were symptomatic, awaiting testing results.

"To date, there have been a small number of confirmed positive cases in the congregation. Sadly, one of those has died," Faith Presbyterian Church said in a statement to KCRA3. "On March 12, Faith Presbyterian Church staff discovered that a small number of church members were displaying symptoms potentially associated with COVID-19. That evening, the church leadership met and made the immediate decision to close the church facility on Florin Road to prevent spread of the virus in our congregation and community."

The church added it is closed until at least April 3.

Its dismaying that testing is still so limited because based on those five (people), that probably every active church member should be tested," Tillman said. "Because who knows? I could be a carrier. So it would probably be reassuring to know that I am not carrying it, and therefore I am not risking my grandchildren carrying it to somebody else.

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Sacramento woman dead from COVID-19 attended church with others who have virus - KCRA Sacramento

Mark Gallagher, a consultant cardiologist, is at home with a temperature of 38 and is pretty certain he has Covid-19. But the NHS will not test him for it. Instead, he has paid for a test kit from a private UK clinic and a colleague in China is sending him another.

Gallagher has been in and out of his London hospital every day for the last 28 in a row. In the past couple of weeks he saw maybe 70 people in outpatients, he said.

He cannot understand why the NHS will not test him or other healthcare workers who are put at risk by their work and risk infecting other vulnerable patients in turn, as well as their families. The policy is that I dont need to be tested and even the people who have been in contact with me arent going to be tested, he said.

They are abandoning the basic principles for dealing with an epidemic, which are to test whenever possible, trace contacts and contain. Almost all individual physicians I know feel that what they are doing is wrong.

Last week, a woman of 79 was admitted to his care for an elective, non-urgent procedure. She was then diagnosed with Covid-19, which, he says, she almost certainly acquired on our wards. She was put on a ventilator but died on Monday night.

Im sure she will go down as an elderly patient with underlying conditions, but she should have lived to 90, he said. Approximately 50 nurses dealt with her and many doctors. None has been tested. All are still at work.

Gallagher says he needs to know whether he has Covid-19. Of the colleague in China who is sending him a test kit, he says: He runs a similar unit to ours. They had to shut half the hospital for six weeks and make it a Covid-19 hospital, but for the last two weeks they are up pretty much as normal.

Except, he says, that every patient scheduled to come in is tested first for Covid-19. If the test is negative as these days it usually is they will be admitted after a second negative test on arrival. They went through a total lockdown and they tested and tracked the contacts of every single suspected case and tested them as well. Thats how you kill an epidemic, he said.

Although the self-isolation policies announced by the prime minister on Monday were a slight improvement, Gallagher feels they are not enough. It could be eliminated if we worked really hard, but there is a policy of surrender, he said.

Our in-house occupational health and infection control teams are competent and hard-working and the infection control people have been at excellent and brave, circulating on the affected wards, he said.

The problem is the instructions coming out of Public Health England and the government, which is attempting to control the UK epidemic by mathematical modelling.

Any such model is only as good as the input data, and the data going into this one are not necessarily applicable to the UK being based on countries with very different behaviour patterns, he said. They are also solely intended to flatten the curve, when even a flat curve will kill thousands. These approaches would be an acceptable experiment if there were no alternatives but we have strategies from elsewhere that have been shown to work.

We should be learning the lessons, he says, from the sharp lockdown in Hubei and the very energetic contact tracing that has taken place in South Korea, Hong Kong and Singapore. The approach of the UK falls far short of that.

The rest is here:

There is a policy of surrender: doctor on UKs Covid-19 failures - The Guardian

The federal health department says it sees merit in a newly developed rapid Covid-19 testing kit able to return results within 15 minutes, which experts say could help relieve significant pressure on pathology services.

Australias chief medical officer, Brendan Murphy, has warned the country faces extreme pressure supplying enough testing kits as the rate of infection continues to skyrocket, warning last week that the number of pathology testing kits, reagents and swabs was deteriorating rapidly with some regions now completely out of supplies.

The government has so far refused to say how many testing kits remain in the country, although the health minister, Greg Hunt, said on Tuesday the supply was sufficient for current requirements.

As the virus spread in Wuhan, Chinese researchers developed a more rapid point of care screening test, which detects antibodies that emerge some time after Covid-19 symptoms appear. A study in the peer-reviewed Journal of Medical Virology said the test could return results within 15 minutes, much faster than the current standard testing.

The test known as the COVID-19 IgG/IgM Rapid Test Kit is not currently in use in Australia, but the Guardian understands some companies are seeking to supply it onto the market.

A spokeswoman for the Department of Health said the rapid test had merit and that there were no compelling reasons not to use it based on the described science and methodology.

But she said the company behind it, the Nantong Egens Biotechnology Company Ltd, had not yet approached the regulator, the Therapeutic Goods Administration, for assessment and approval.

Such a device would need to be approved through the TGAs in-vitro diagnostics regulatory scheme before use, the department said.

The company has had the test validated by laboratories in Europe and China. But the spokeswoman said the same would need to occur in Australia.

Tests also require validation by testing laboratories in the Australian context before use, she said.

The Department of Health, in collaboration with the Public Health Laboratory Network, is monitoring the development of test kits and methodologies and their performance as they are used more widely around the world.

In Australia, a company called COVID-19 Rapid is representing three manufacturers seeking to get TGA approval for the rapid tests. A company spokesman said: Our TGA consultants have told us that unlike the US and Europe, securing approval will take too long and be very expensive.

Experts approached by the Guardian said the testing had potential benefits and drawbacks. The testing does not require a laboratory, which could help alleviate pressure on Australias pathology services and the rest of the health system.

Peter White, a virologist from the University of New South Wales, said if it were possible for rapid tests to be used by people at home it would help take the burden off an already strained health system.

These tests will be useful for sure, they could keep infected people out of the health system and they do also provide peace of mind, he said.

There are certainly some advantages. If someone thinks they have the virus and can do the test at home in 15 minutes thats someone who isnt presenting at a hospital, GP or pathology lab.

Even if you received a false positive, if you were able to take the precaution of having it backed up with [a traditional test] it would be good. If people received a negative result, they might be less inclined to visit the clinic which is going to free up hospital resources.

But, he stressed, the tests were not always as reliable as those currently being used in Australia. Because rapid test kits look for antibodies associated with the virus rather than the virus itself, they could record false-negatives if used at the wrong time.

The question is how significant those limitations are. It depends really on how many true cases you detect. Does it detect every positive, or does it miss 5%? he said

Because if you have to back up every test with a lab pathology test it might defeat the purpose a little bit.

Bill Bowtell, an infectious diseases expert from the Kirby Institute, said while there was no shortage of medical supply companies looking to profit off the Covid-19 crisis, the TGA would need to consider the kits closely.

In the end, anybody with anything to sell is in the market and their interest is to make the biggest claims, he said.

I think thats the case with a lot of the things that well see coming onto the market. Theres uncertainty because it didnt come to market after stringent testing, it came to the market because theres a feeling of my god we need it.

In normal circumstances you wouldnt touch it with a barge pole but this is what happens when theres a crisis.

Originally posted here:

New rapid Covid-19 testing kit can return results in 15 minutes but not yet available in Australia - The Guardian

Retired or not fully qualified nurses and other medical staff could be called in to help tackle the coronavirus pandemic, and given protection against any negligence claims, among a sweeping range of measures planned under emergency legislation.

Another possible power would allow police or immigration officers to detain a person for a limited but unspecified period if they might be infectious and to take them to a suitable place to enable screening and assessment.

The laws, expected to be introduced to the Commons on Thursday, will also give ministers the power to ban gatherings or events and temporarily close schools and colleges in the effort to curb the spread the virus.

An outline of the planned new laws, released on Tuesday evening, says the measures will be time-limited to two years and will not all come into force immediately, allowing the UK and devolved governments to switch on these new powers when they are needed.

It adds: The measures in the coronavirus bill are temporary, proportionate to the threat we face, will only be used when strictly necessary and be in place for as long as required to respond to the situation.

A key change would be to allow medical regulators to create emergency registrations for suitable people to become nurses, midwives or paramedics, such as those who have recently retired and students near the end of their training. The document does not mention doctors in relation to this.

They would be given indemnity for clinical negligence liabilities arising from NHS activities linked to the coronavirus outbreak, where none was in place.

Measures to encourage returnees would include suspending a rule that stops some NHS staff who return after retirement from working more than 16 hours per week, ensuring they do not lose out under pensions.

Other measures are intended to help ease pressures on NHS staff, such as changing mental health legislation so people seen as being a risk to themselves or others can be forced to have treatment on the opinion of just one doctor, not two.

Time limits as to when such people must be allowed to leave will also be extended or removed as needed.

Also, the obligation on some councils in England and Wales to provide certain statutory social care services could be eased to ensure the most urgent and serious care needs are met, even if this means not meeting everyones assessed needs in full or delaying some assessments.

While government guidance on avoiding pubs, bars and other crowded places is now voluntary, the new laws will allow the government to restrict or prohibit events and gatherings during the pandemic in any place, and to temporarily close educational establishments and childcare providers.

Another possible power would allow ministers to close ports or airports if too many Border Force staff are off sick. Others will expand the use of video and audio links in court proceedings.

A notably gloomy section is connected to the expectation of a rise in deaths, with one allowing a greater range of people, among them funeral directors, to register a death for the family.

A final part gives the power to extend statutory sick pay to all days off work, as promised by ministers.

Matt Hancock, the health secretary, said any new measures will only be used when it is absolutely necessary and must be timed to maximise their effectiveness, but crucially they give the government the powers it needs to protect lives.

He added: By planning for the worst and working for the best we will get through this, but this is a national effort and we must all work together from businesses prioritising the welfare of their employees, to people thoroughly washing their hands.

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Retired and student medics may be called in to tackle Covid-19 in UK - The Guardian

A Texas-based health care system announced Tuesday that it would convert one of its hospitals in Boston into a treatment center specifically for patients with Covid-19, taking special measures to clear the air of contamination and increasing its supply of ventilators and personal protective equipment.

The company, Steward Health Care, said Carney Hospital, located in Bostons Dorchester neighborhood, would become the nations first dedicated care center for treating patients with Covid-19, the disease caused by the novel coronavirus.

In a statement Tuesday, Steward Health Care said, among other measures, crews are adding negative pressure systems that clear the air of any contamination. The goal is to ensure that people who are hospitalized with severe Covid-19 infections can receive the dedicated care some require, as well as to allow regular operations at the companys other sites.

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We are prepared for an influx, the company said, though, as of now, the companys hospitals nationwide have treated just 10 patients with confirmed infections. The company, which is based in Dallas, has 35 community hospitals in nine states.

A significant amount of our resources remains centralized, ready to be deployed or redeployed across our different regions if and when they are needed, the company said.

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Hospitals around the country have already been allotting certain floors to treat Covid-19, canceling elective surgeries and other procedures that can be delayed, and postponing some appointments.

The concern is that a crush of Covid-19 patients could require all of a hospitals resources and equipment. Though its estimated that only a few percent of infections cause critical disease, a rapid spread of the virus throughout communities could still leave thousands of patients requiring intensive care and needing to be put on ventilators for long stretches of time.

Already, some hospitals have reported shortages of personal protective equipment like masks, gloves, and gowns, and some providers have said they have resorted to cleaning and reusing supplies they would have normally discarded. Though the availability of supplies varies around the country, some facilities have said theyre facing a lack of basic materials as well, including nasal swabs that are needed to conduct test for the virus.

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Hospital in Boston will be converted into Covid-19 treatment center - STAT

What is COVID-19 (a.k.a. the new coronavirus?)

According to the World Health Organization, coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases. Examples include the Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans. COVID-19 stands for "Coronavirus disease 2019," which is when this strain of the coronavirus was discovered.

What are the symptoms?

The CDC says patients confirmed to have the 2019-nCoV reportedly had mild to severe respiratory illness with:

Prevention

The CDC is recommending "common sense" measures such as:

Governor Bill Lee's guidance for mass gatherings, schools, state employees and the state capitol building to prevent the virus' spread:

Mass Gatherings

The CDC recommends gatherings of 10 people or more in the U.S. be canceled or postponed over the next eight weeks. The CDC added this advisory does not apply to placed of business and schools.

Schools

Tennessee schools are urged to close as soon as practically possible, with all schools expected to close by March 20. Schools should remain closed through March 31 to further mitigate the spread of the infectious disease.

State Employees, Business Travel

Effective immediately, state employees who have been trained and certified to work from home within the states Alternative Workplace Solutions (AWS) program will work from home through March 31, 2020. Approximately 11,000 state employees are certified AWS employees and can begin work from home with no disruption to state business.

Effective immediately, state employees have been instructed to cease all non-essential business travel through March 31, 2020.

Tennessee State Capitol Closed to Visitors

The Tennessee State Capitol is closed to tours and visitors through March 31, 2020. Members of the media will continue to have access to the State Capitol building.

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78 cases of COVID-19 confirmed in Tennessee - NewsChannel5.com